Gingercroft Residential Home

Action was taken when things had gone wrong. There was more structure in place to record, monitor and analyse accidents and incidents. People were supported by other health professionals, where needed. Staff received handovers – some felt this was not always successful in ensuring all staff were aware of changes in people’s needs, however a new system had been introduced to improve this. People were kept safe. Staff understood their safeguarding responsibilities and there were systems in place to ensure concerns were reported. People had been supported to reduce risks to their health and support needs – care plans were in place and staff knew people well; however, improvements were needed to ensure plans were always up to date and contained enough detail. Professionals were generally complimentary of the service; although 1 felt improvements were needed to increase the amount of detail in some care plans to ensure staff had a complete picture of people’s needs. There were some gaps in records, such as in repositioning records or in blood pressure monitoring for 1 person. Improvements were needed in the environment. Some areas could not always be kept hygienically clean due to their condition. There were exposed pipes in 1 bedroom which could pose a risk. Other checks were made on the building to ensure it remained safe. Improvements were needed to infection control measures in place as we observed some unsafe and undignified practice. The provider was working on an infection control action plan from the external infection control professionals to resolve issues, but this had not yet been fully completed. Staffing levels were monitored although improvements were needed with this; there had been no impact from this, but it had been recognised more staff were needed but this was not yet in place. Medicines were generally managed safely.

We did not assess all quality statements within effective at this assessment. The rating from the previous inspection has been partially used to rate this key question. At this assessment, there was mixed feedback about the food, some people were positive, but others felt there was not always enough choice. We observed 1 person who did not have a meal that was fully inline with their dietary advice, although they did not come to harm as a result of this. Another person had a choking incident recorded, but there was a lack of evidence action had been taken in response to this. People were supported to make decisions and staff understood what mental capacity meant. However, improvements were needed in the assessing of people’s capacity and in ensuring all restrictions had been considered and included in assessments and in referrals to others.

The provider had responded to feedback, both from the CQC and from other professionals, such as the local authority to address concerns and improve care and support to people. Staff were positive about working in the service and enjoyed working there. There were regular team meetings, but more feedback was needed from people and relatives. People and staff were positive about the approachability of the registered manager and deputy manager. However, feedback abut how effective the registered manager was, was mixed. Staff felt there was confusion about the rotas, and this caused issues for them as they were not always effectively managed. Staff felt feedback was raised and it was not always clear action was taken in response to this feedback. The local authority had been monitoring the service and felt improvement had been slow far. However, the service worked in partnership with other professionals and agencies. A new electronic system had been put in place following the last inspection, which had improved the oversight of care. Many new audits had been introduced to improve the effectiveness of the oversight of the service. However, these processes were changing in order to identify the best process for the service, so these were not yet fully embedded or sustained. There were some omissions we identified which had not yet been resolved, but we will check improvements continue the next time we assess the service.